# CAROLINAS PHYSICIANS NETWORK INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CAROLINAS PHYSICIANS NETWORK INC
- **Other names:** Wesley Chapel Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164770467
- **Legal business name:** CAROLINAS PHYSICIANS NETWORK INC
- **Authorized official:** DANIEL L WIENS (ADMINISTRATION)
- **Authorized official phone:** (704) 355-0648

## Contact information

- **Practice address:** 5955 WEDDINGTON RD, WESLEY CHAPEL, NC 28104-6296
- **Practice address phone:** (704) 667-4280
- **Practice address fax:** (704) 667-4281
- **Mailing address:** PO BOX 601888, CHARLOTTE, NC 28260-1888
- **Mailing address phone:** (704) 667-4280
- **Mailing address fax:** (704) 667-4281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2012
- **Last updated:** 07/24/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5917907 | — | NC |
| 05 | — | QPB648 | — | SC |